Pain Physicians of Indiana PC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

PAIN PHYSICIANS OF INDIANA PC

Practice address

8687 Connecticut St
Ste D
Merrillville, IN 46410-5541

Phone

(219) 750-9630

Fax

(219) 750-9451

NPI assigned

Apr 4, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tarek Hassan Shahbandar, M.D.

Title

Ceo/President

Phone

(219) 750-9630

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Interventional Pain Consultants Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445299200000",
    "number": "1952667859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10685",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464110685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8687 CONNECTICUT ST",
            "address_2": "STE D",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105541",
            "telephone_number": "219-750-9630",
            "fax_number": "219-750-9451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN PHYSICIANS OF INDIANA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-04",
        "last_updated": "2015-10-20",
        "status": "A",
        "authorized_official_last_name": "SHAHBANDAR",
        "authorized_official_first_name": "TAREK",
        "authorized_official_middle_name": "HASSAN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "219-750-9630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201066350A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Interventional Pain Consultants",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Pain Medicine (Anesthesiology) Physician in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Pain Medicine (Anesthesiology) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.